Lymphadenopathy and fever in a chef during a stay in Europe

Abstract

This case illustrates a rare presentation (as lymphadenopathy and fever) of one of the most common zoonotic diseases worldwide--brucellosis--in a 22-year-old Brazilian male (a chef) who had recently returned to Brazil after having lived in and traveled around Europe for one year. The histopathology, clinical history, and response to treatment were all consistent with a diagnosis of brucellosis, which was confirmed by PCR in a urine sample. We also review some aspects of brucellosis, such as the clinical features, diagnosis, and management.

Figure 1 -. (A) Chest X-ray, posteroanterior view, showing a widened paratracheal stripe (arrow). (B) Highresolution CT of the chest revealing enlarged mediastinal lymph nodes (arrow).

Figure 2 -. Photomicrographs of a cervical lymph node biopsy sample. Lymphoid tissue is replaced by necrotizing granulomatous inflammation (panel A). Note palisading epithelioid cells (panel B, arrows), extensive neutrophil-rich suppurative necrosis (panel C, letter N), and scattered giant cells (panel D, arrows). Hematoxylin-eosin staining (magnification varies; see the scale bars displayed in the panels).